Download MBBS (Bachelor of Medicine and Bachelor of Surgery) Latest Extrahepatic Biliary Apparatus Lecture PPT
EXTRAHEPATIC BILIARY
APPARATUS
INTRAHEPATIC
BILIARY SYSTEM
NOT
OUR BUISNESS
EXTRAHEPATIC BILIARY APPARATUS
Consists of :
1. Rt. hepatic duct
2. Lt. hepatic duct
3. Com. hepatic duct
4. Cystic duct
5. Com. Bile duct
6. Gallbladder
HEPATIC DUCTS
? Emerge from
porta hepatis
? Rt. & Lt. HDs
unite to form
Common Hepatic
Duct(CHD)
? CHD =4 cm
? CHD descend in
lesser omentum
? Joined by cystic
duct to form CBD
GALL BLADDER
Pear shape
?7-10 cm in length
?Up to 50 Ml
?In the gallbladder
fossa on the visceral
surface of the liver
Gall Bladder(Parts)
?Fundus
?Body
?Neck
?Infundibulum
(Hartmann's pouch)
Surface projection of
fundus: Right linear
semilunaris// right costal
margin = Murphy's point
RELATIONS OF
GALLBLADDER:
ANTERIORLY:
? Ant. Abdominal wall
? Inferior surface of
liver
POSTERIORLY:
? Transverse colon
? 1st & 2nd
duodenum
CYSTIC DUCT
? 3.8 cm
? Somewhat S shaped
? Its mucous membrane
is forming a spiral fold
( the spiral valve )
CALOT'S TRIANGLE
Moynihan's hump
BLOOD SUPPLY:
?ARTERIAL :
Cystic artery
? VENOUS :
Cystic vein
? LYMPHATICS :
A cystic LN at the neck
of GB
? NERVES :
Autonomic from
coeliac plexus
Cholecystokinin
BILE DUCT/COMMON BILE DUCT
? 8cm(3 inch) long &
about 6mm in dia.
? 1st course (Lesser
Omentum)
? 2nd course
(behind 2nd Duo.)
? 3rd course ( post.
To head of
pancreas )
Blood supply of Bile Duct
SPHINCTERS
Clinical points:
? Gallstones
? Biliary colic (epigastric pain, jaundice &
pancreatitis)
? Acute cholecystitis & referred pain to
shoulder
? Cholecystectomy ( variations )
? Gangrenous ( single arterial supply )
? Biliary atresia
Imaging of the Biliary Tract
1. Cholecystography
2. Ultrasound
3. Endoscopic Retrograde
Cholangiopancreatography(ERCP)
4. Magnetic Resonance
Cholangiopancreatography(MRCP)
Endoscopic retrograde
Magnetic resonance
cholangiopancreatography(ERCP)
cholangiopancreatography(MRCP)
This post was last modified on 30 November 2021